Blog / Compliance
14 Questions to Ask a Wellness Marketing Agency Before You Sign
Picking a paid media partner in wellness works nothing like picking one in ecommerce or local services. Same platform mechanics, completely different constraints. Your ads run under Meta's Special Ad Category. Your claims get read against FDA and FTC standards most marketers have never opened. One careless creative can take down an ad account that took two years to warm up. The wrong agency does not merely waste spend. It costs you a restricted asset and a stalled pipeline.
Overview
Trouble is, every agency sounds the same on a sales call. Everyone specializes in wellness. Everyone has a dashboard and a results claim. Whatever separates a genuine specialist from a generalist with a wellness page never surfaces in the pitch. It surfaces in the answers to operational questions a generalist has never had to think about.
What follows is the rubric. Fourteen questions, why each matters, what a strong answer sounds like, and what should make you slow down. Ask all fourteen of every agency on your shortlist, the one you are leaning toward included. Write the answers down. By the third call the pattern is obvious.
1. Which specific wellness verticals have you run paid ads in
Wellness is not one market. Selling a hyperbaric chamber to a clinic owner has almost nothing in common with filling injectable appointments, and neither resembles a telehealth membership billed monthly. Vertical experience decides one thing: whether the agency already knows your cost structure, compliance exposure and seasonality, or whether you are funding their education.
A good answer sounds like: a specific list with texture. They name the verticals, separate what they run today from what they ran years ago, describe how the funnels differ, and volunteer where they are weak. An agency that names the categories it declines, and the reason, is telling you something real.
A bad answer sounds like: "We work across health and wellness." Or a list running from dentistry to software to home services with wellness dropped in the middle. Breadth is not depth, and in a restricted category, depth is the entire job.
2. Are you a Member of Meta Business Partners
Binary and verifiable, which is exactly what makes it useful. Member of Meta Business Partners status requires meeting Meta's performance and account standards and appearing in Meta's own partner directory. It guarantees nothing about the quality of the work. It does confirm the agency operates at scale inside the platform and answers to it.
A good answer sounds like: a clear yes, stated verbatim as Member of Meta Business Partners, with a link to their directory listing so you can confirm it yourself in thirty seconds.
A bad answer sounds like: vague adjacent claims. "We are a Meta partner agency." "We have a rep over there." No directory listing means no. Be just as cautious with anyone hinting at special influence or private channels that get ads approved. Platform policy does not work that way, and the pitch itself is the red flag.
3. How do you handle Meta's Special Ad Category restrictions
Almost every wellness advertiser is either in the Special Ad Category already or one creative away from it. Being in it costs you granular targeting inputs, certain lookalike behavior, and tight geographic radii. An agency without a strategy for that constraint will quietly underperform and blame the market.
A good answer sounds like: they explain what triggers the classification, what gets stripped out, and how they compensate. Expect creative doing the work audiences used to do, broad structures built to feed strong signal, geographic strategy designed for wider radii, and conversion tracking that survives restricted data sharing.
A bad answer sounds like: surprise. If they ask what you mean, or claim they stay out of the category by wording ads carefully, you just found the ceiling of their experience. Nobody words their way out of a classification, and trying is how accounts get flagged.
4. Who owns the ad account and the pixel, us or you
The most expensive question on this list. When the agency owns the ad account, the pixel, the conversion history and the page assets, your entire advertising history belongs to them. Leaving means restarting with a cold pixel. That is a soft lock-in, and it has nothing to do with how good their work is.
A good answer sounds like: you own everything. The ad account, the pixel or dataset, the Business Manager and the creative files sit under your business entity, and the agency holds partner access to work inside them. They should also state what happens on exit: access is revoked, assets stay, no history moves.
A bad answer sounds like: "We run everything through our Business Manager, it is simpler." Simpler for them. Ask what you walk away with if you terminate tomorrow. If the answer involves rebuilding a pixel, you have learned everything you need about the engagement.
5. Do you run our media spend on your card or ours
Agencies that front or hold client media introduce two risks. One is financial. Your budget sits inside someone else's cash flow, and when that cash flow tightens, your campaigns are the flex. The other is transparency. Once spend passes through an intermediary, verifying what actually got spent gets harder, and markup can hide in the gap.
A good answer sounds like: media bills directly to your own payment method inside your own ad account, and the agency fee is separate and clearly stated.
A bad answer sounds like: any structure where the agency pays the platform and invoices you for media. Ask whether they mark it up. Ask whether you can see raw platform billing. Hesitation on either question is the finding.
6. How do you review creative for FDA and FTC claim compliance before it goes live
Platform policy and federal regulation are separate systems, and an ad can clear one while violating the other. Meta approving your ad is not a legal opinion. The FTC cares about substantiation, typicality of results and disclosure of material connections. The FDA cares whether your language turns a general wellness product into an unapproved device or drug claim.
A good answer sounds like: a documented pre-flight review they can describe step by step. A claims checklist, a banned-phrase list per client, testimonial disclosure rules, device language kept inside the clearance, and a named person who signs off. They should also know where their review ends and your medical or legal counsel begins.
A bad answer sounds like: "We keep it compliant" with no mechanism behind it, or an assumption your legal team will catch problems downstream. Watch too for eagerness to write aggressive before-and-after copy, outcome guarantees, or condition-treatment language for a product that is not cleared for it.
7. What happens when an ad gets rejected or the account gets restricted
Not if. When. Rejections are routine in wellness, and restrictions land on careful advertisers too. The separator is whether a defined response exists or a scramble starts. Downtime during a restriction is revenue you never get back, so the process matters far more than the reassurance.
A good answer sounds like: a tiered process. Triage the rejection reason, establish whether it is creative-level or account-level, fix and resubmit where that applies, and escalate through documented platform channels when it is structural. Expect them to mention diversified campaign structures so one rejection cannot halt delivery, clean business verification, and a written appeal history. Honest agencies will also say some appeals fail, and what the contingency is.
A bad answer sounds like: "That never happens to us." It happens to everyone. Walk away from anyone describing spare accounts spun up to dodge a restriction, or any version of gaming review. That risk compounds onto your business entity, not theirs. Reading up on ad account recovery first will help you judge the answer you get.
8. Is the work done in-house or white-labeled to a subcontractor
Plenty of agencies sell the relationship and outsource the delivery. Disclosed, that can work fine. Undisclosed, it means the person touching your account has no context on your vertical, no accountability to you, and dozens of unrelated accounts running off a template.
A good answer sounds like: a direct statement of where the work happens, including any contractors, what they handle, and how their output is reviewed before it reaches your account.
A bad answer sounds like: deflection into process language. "We have a team." "Our production partners handle execution." Ask the follow-up: is the person building my campaigns an employee, and can I speak with them. The reaction tells you most of what you need.
9. Who is actually working on my account day to day
Agencies routinely staff the sales call with senior people you never see again after signature. What you want is the name, role and account load of whoever will be inside your Ads Manager on a Tuesday morning.
A good answer sounds like: named people with defined roles, a split between who sets strategy and who executes, a realistic account load, and a clear escalation path when something urgent breaks.
A bad answer sounds like: "You will have a dedicated account manager" with no name attached, or a structure where your only contact cannot answer a technical question without checking with the team. Every layer between you and the operator slows down every decision for the next year.
10. What does your reporting look like and how often
Reporting is where agencies hide. Dashboards stuffed with impressions, reach and engagement are built to look like performance without reporting on it. What you need is a line of sight from spend to qualified lead to booked appointment or purchase, plus a narrative explaining what changed and what comes next.
A good answer sounds like: a fixed cadence, a live dashboard you can open any time, and written analysis on a schedule you can hold them to. They should show you a real report template on the call, with revenue-connected metrics at the top, and name the tracking they need in order to report honestly.
A bad answer sounds like: a monthly deck of platform screenshots, or reporting that stops at cost per lead with no curiosity about what happened after handoff. Ask whether they want access to your booking or CRM data. An agency that never asks for the back half of the funnel is not optimizing against it.
11. What is the minimum engagement length and why
Minimums are not automatically predatory. Paid social in a restricted category needs time to produce clean signal, and creative testing needs enough cycles to reach conclusions. The real question is whether the agency justifies the term with reasoning or with convenience.
A good answer sounds like: a specific term tied to your funnel length and testing cadence, plus honesty about what happens if it is not working.
A bad answer sounds like: a long lock with no rationale, or auto-renew language buried in the agreement. Be equally wary of no minimum at all in a category this slow to stabilize.
12. How do you define success in month one versus month six
This one separates operators from salespeople faster than anything else on the list. Month one and month six should not share a scoreboard. Early on, success is infrastructure and signal. Later, it is efficiency and volume at a cost you can sustain.
A good answer sounds like: different definitions per phase. Month one might be tracking verified, account structure built, compliance review passed, first creative cohort live, baseline cost per lead established. Month six should be about qualified lead volume, cost per booked appointment, creative win rate and contribution to revenue.
A bad answer sounds like: a revenue promise attached to a date, or guaranteed lead volume quoted before they have seen your tracking, your offer and your close rate. Confident forecasting from someone who has not looked at your data is a sales technique, not a plan.
13. Can you show work in my specific vertical
Ask for proof. Then ask for the unflattering version. What you want is an account story with a timeline: the starting situation, what they changed, what happened, and what failed along the way.
A good answer sounds like: documented work in your vertical or one with the same constraints, named where permission exists and anonymized where it does not. They should discuss the creative approach, the offer, the structure and the misses. Ask to speak with a current client, not a hand-picked reference from two years ago. Published case studies are a starting point, the conversation behind them is the test.
A bad answer sounds like: unverifiable numbers with no context, results from a vertical nothing like yours, or reluctance to connect you with an existing client. Show only wins and unable to name one account that did not work, and they are either new or editing.
14. What would make you turn down a client like us
The trust question. Every agency worth hiring declines work, and the criteria reveal what they actually believe about their own model. An agency that has never said no is either desperate or indifferent to fit. Both cost you.
A good answer sounds like: specific, slightly uncomfortable criteria. A real specialist will say things like: we decline brands whose claims we cannot substantiate, we decline when an offer has never converted for anyone and paid traffic is being asked to fix a product problem, we decline when the budget cannot sustain enough testing to reach a conclusion. They should also tell you plainly if part of your business falls outside what they do well.
A bad answer sounds like: "We would never turn you down," delivered as a compliment. It is not one. It means fit is not a filter, which means the model runs on client volume rather than performance per client. Push once more. Ask them to describe the last client they said no to and why. The specificity of that story is the real answer.
Before you sign anything
Print the fourteen questions. Ask every agency the same ones in the same order, and watch which answers arrive instantly and which get reframed into a pitch. Specialists answer operational questions operationally. Generalists answer them with positioning.
If you want to go deeper on the constraints these questions are testing for, our guides on wellness ad compliance and Meta advertising for wellness brands cover the ground, med spa marketing goes vertical-specific, and the verticals we work in will tell you quickly whether your category is one we know well. Use the rubric on us too. That is the point of writing it down.
Frequently Asked Questions
How many agencies should I actually talk to before deciding?
Three is usually enough to calibrate, five is the practical ceiling before the calls blur together. Volume is not the value. Asking the identical fourteen questions to each one is, because that is what surfaces the differences.
Is a wellness specialist really better than a large generalist agency?
In a restricted category, usually yes, because the failure modes are specific. Special Ad Category structure, claim substantiation, device language and restriction response get learned through repetition inside the category. A generalist may have more resources, but if your account is their only wellness client, you are funding the learning curve.
What is the single biggest red flag in an agency sales process?
Anyone suggesting they can influence or shortcut platform review. It signals a compliance problem and a misunderstanding of how enforcement works at the same time, and the consequences land on your assets, not the agency's.
Should I let an agency run ads inside their own Business Manager?
No. Your ad account, pixel or dataset and Business Manager should be owned by your entity, with the agency granted partner access. Setting it up correctly at the start costs nothing and it protects your entire advertising history if the relationship ends.
How long before I can judge whether the engagement is working?
Judge leading indicators early and lagging ones late. Tracking accuracy, creative volume shipped and approval rate are visible within weeks. Cost per booked appointment and revenue contribution need enough completed sales cycles to mean anything, which for most clinics and device brands is at least a full quarter.
Do I need my own legal or medical review if the agency does compliance checks?
Yes. An agency review catches platform and claim risk before publication, which prevents most problems. It does not replace your own regulatory counsel, particularly for cleared devices or prescribed treatments.
About the author
Alex Evans is the founder of Raging Agency, the wellness marketing specialist behind the hyperbaric chamber engagement and patient acquisition systems for premium med spas, longevity clinics, and biohacking studios. Connect: @AlexEvans997 on Instagram, author archive.
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